Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 17058 | CO |
NPI | 1194782250 |
---|---|
Provider Name | Dennis Maurice Weisbrod |
First Address | Denver, CO 80218-1216 |
Second Address | Denver, CO 80218-1216 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 10/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01170588 | (05) | CO |
04760088 | (05) | CO |
D23182 | (02) | CO |